Dr. Miguel A. Lipka

Disc Herniation

A spinal disc herniation is a medical condition affecting the spine, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out. This tear in the disc ring may result the patient feeling severe pain.

Anti-inflammatory treatments are commonly used for pain associated with disc herniation, protrusion, bulge, or disc tear.

Cervical Disc Herniation

The cervical spine consists of the top seven bones, called vertebrae, in your spine located between the skull and chest.

Cervical disc herniation usually develops in people aged 30 - 50. It may originate from some sort of trauma or injury to the cervical spine.

The first symptom of cervical disc herniation is usually neck pain. Others symptoms may include:

Pain in one arm or in both arms

Limited head and neck motion, especially turning to the side of the herniated disc

Hyperactive reflexes

Spasticity

Loss of bladder or bowel control, erectile dysfunction

Symptoms can typically be eased with pain medication and conservative (non-surgical) treatments. All treatments for a cervical herniated disc are essentially designed to help resolve the arm pain. The weakness and numbness/tingling usually will resolve with time.

Thoracic Disc Herniation

The thoracic spine consists of the 12 vertebrae between your neck and lower back. The ends of your ribs, although not attached to the spine, rest in indentations in the thoracic vertebrae that help support the ribs. This arrangement also makes the thoracic vertebrae more stable than other vertebrae.

Disc herniation in the thoracic spine is relatively rare compared to the lumbar vertebrae in the lower back and the cervical vertebrae in the neck. Thoracic disc herniations account for less than 1 percent of all protruded discs.

Most often, thoracic disc herniation is treated with bed rest and pain medication. However, surgery may be recommended if the condition doesn't respond to conservative treatment or if the disc is impinging on the spinal cord and causing symptoms or signs of spinal cord dysfunction.

Surgical treatment consists of removing the damaged disc or discs, a procedure called a discectomy. It also may include removing the lamina, the upper part of the vertebrae, to give the spinal cord more room.

Lumbar Disc Herniation

The lumbar spine consists of the five vertebrae in the lower part of the spine, each separated by a disc, also called a lumbar disc. The discs in this part of the spine can be injured by certain movements, bad posture, being overweight and disc dehydration that occurs with age.

Although the lumbar vertebrae are the biggest and strongest of the spinal bones, risk of lumbar injury increases with each vertebrae down the spinal column because this part of the back has to support more weight and stress than the upper spinal bones.

The lumbar disc is the most frequent site of injury in several sports including gymnastics, weightlifting, swimming and golf, although athletes in general have a reduced risk of disc herniation and back problems.

Symptoms of disc herniation in the lower back are slightly different from symptoms in the cervical or thoracic parts of the spine. The spinal cord ends near the top lumbar vertebrae but the lumbar and sacral nerve roots continue through these spinal bones. A lumbar disc herniation may cause:

Lower back pain

Pain, weakness or tingling in the legs, buttocks and feet

Difficulty moving your lower back

Problems with bowel, bladder or erectile function, in severe cases

Conservative treatment of lower disc pain usually is successful over time. It includes:

Anti-inflammatory medication such as aspirin, ibuprofen and acetaminophen

Physical therapy

Steroid injections

Education in proper stretching and posture

Rest

However, surgery may be recommended if your pain doesn't respond to conservative treatment in two to four weeks, your condition affects your bowel or bladder function, or if it threatens permanent nerve damage. Only about 10 percent of adult lumbar disc patients require surgery and even fewer children and adolescents.